Nicholas Wayne Blackwell, RPH. PHARM. D.
Individual provider Active NPI Ambulatory Care Pharmacist · Hearne, TX
NPI 1689280505 · NPPES record last updated Sep 16, 2020
Key facts
- NPI
- 1689280505
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ambulatory Care Pharmacist 1835P2201X
- License
- 58974 (TX)
- Practice address
- 400 W 2ND St
Hearne, TX 77859-2566 - Phone
- (979) 492-2404
- Fax
- (979) 279-3374
- NPI assigned
- Sep 16, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58974 | TX | MD | Ambulatory Care Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 58974 | TX | Yes |
Addresses
Primary practice location
400 W 2ND St
Hearne, TX 77859-2566
Mailing address
400 W 2ND St
Hearne, TX 77859-2566
Phone (979) 492-2404
Other providers in Hearne, TX
- Amayzing Diagnostic Services Inc
- Brazos Valley Community Action Agency, Inc.
- Brookshire Brothers Inc
- Regina Butuk
- Cameron Calame
- Steven Marc Catalina
All providers in Hearne, TX · Ambulatory Care Pharmacist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.